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FACTORS IMPACTING ON THE MORBIDITY OF BRONCHOPULMONARY DYSPLASIA


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Abstract

The severity of the course of bronchopulmonary dysplasia (BPD) in the population changes due to the increase in the number of children born with very low and extremely low body weight, the introduction into the practice of new standards of respiratory support for premature infants, drug prevention and treatment of this pathology. The aim of the work is to determine the influence of BPD form, gestational age, birth weight, concomitant diseases on the severity of its course in children. Materials and methods. In 72 BPD children aged from 1 month to 3 years, the severity of the course of the disease was determined according to the computed tomography of the chest organs, using an assessment of the severity in points on a special scale as follows: 0-5 points for mild BPD, 6-10 points - moderate, 11-15 points - severe. Results. In children born after 2012, a moderate course of BPD prevails (8.1 ± 0.32 points), being typical for both the classical (55.1%) and new (69.7%) forms of the disease. The classical form is more severe than the new one (9.0 ± 0.1 and 7.53 ± 0.38 points; p = 0.009). BPD was more severe in children with gestational age less than 28 weeks than in children with gestational age of 29-32 weeks (9.0 ± 0.4 and 7.4 ± 0.6 points; p = 0.000). BPD was more severe in children with birth weight less than 1000 g than in children with birth weight 1000-1500 g (8.79 ± 0.49 and 7.18 ± 0.61 points; p = 0.000). When BPD was combined with patent ductus arteriosus or pulmonary hypertension, the disease progressed more severely than in the absence of these forms of pathology (9.6 ± 0.8, 10.0 ± 0.7 and 7.22 ± 0.34 points; p = 0.031). The severity of changes detected by computed tomography of the chest organs decreases by the age of 3 years, but recovery was not complete in any of the examined patients: 8.6 ± 1.0 points at the age of 6 months and 6.2 ± 0.44 points by 3 years (p = 0.009). Conclusion. In children aged 1 month to 3 years, the severity of BPD is influenced by the form of the disease, gestational age, birth weight, concomitant patent ductus arteriosus or pulmonary hypertension, and the age at which the examination is performed.


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